The Application Of Autologous Dentin Particles And Deproteinized Bovine Bone Matrix In Maxillary Sinus Floor Elevation

Objective:Long-term absence of teeth in the maxillary posterior region often leads to the reduction of vertical bone height and thickness,which makes it impossible to perform routine implantation.When the bone height is extremely insufficient,the lateral window of maxillary sinus floor elevation has been proved to be feasible.In this study,we reviewed the cases of the lateral window maxillary sinus floor elevation using dentin particles and deproteinized bovine bone matrix(Bio-oss)as bone graft materials,and compared the bone regeneration effects of dentin particles and deproteinized bovine bone matrix in the maxillary sinus floor elevation and clinical effects implant restoration treatment,to provide clinical data for the application of dentin particles in the lateral window maxillary sinus floor elevation.Methods: This study reviewed 22 patients,including 14 males and 8 females,with an average age of 55 years(30-69 years),who underwent the lateral window of maxillary sinus floor elevation at the Implant Center of the Affiliated Stomatological Hospital,School of Stomatology,Dalian Medical University from September 2020 to February2023.A total of 35 implants were implanted.The average follow-up was 15 ± 6 months,the longest was 24 months,and the shortest was 8 months.According to the bone graft materials,they were divided into two groups: dentin particles group,10 people,a total of17 implants were implanted;Bio-oss group,12 people,a total of 18 implants were implanted.CBCT was taken before operation to measure the bone volume at the implant site in the edentulous area,and basic periodontal treatment was performed before operation.Under local anesthesia,incise the gingiva,open a window on the side wall,peel off the mucosa of the maxillary sinus and fill in the bone graft material,and implant at the same time or later.CBCT was taken in before、on the day and 6 months after operation.The superstructure was repaired 3-6 months after implantation.Observe the complications and success rate of the operation,compare the changes of bone height,density and volume of the two bone graft materials,the pain,swelling reaction and satisfaction of patients,and analyze the clinical effects of the two bone graft materials in the application of maxillary sinus floor elevation.result:1.Operation complications and success rate: There were 3 cases of maxillary sinus mucosa perforation,2 cases in Bio-Oss group and 1 case in dentin particles group,but the cause of perforation was unrelated to the two bone graft materials,and no infection occurred after treatment.According to the success criteria of implants,one patient in the Bio-oss group had peri-implant inflammation on two implants,the cause of which had nothing to do with Bio-oss,and the success rate was 88.9%;In dentin particles group,the implants function was good,and the success rate was 100%.2.Imaging: During the follow-up,the change of bone height in the dentin particles group was 0.84 ± 0.13 mm,and in the bio-oss group was 0.73 ± 0.18 mm.The change of bone height in the two groups was not statistically significant;The bone volume change rate of bone graft material in the dentin particles group was 10.48 ± 4.26% at 6 months,and that in the Bio-oss group was 12.18 ± 4.59%.The bone volume change rate of the two groups was not statistically significant;The change value of bone density after 6 months in the dentin particles group was 169 ± 65.11,and the change value in the Bio-oss group was140.08 ± 58.33.There was no statistical significance between the two groups.3.Postoperative reaction and satisfaction of patients: there was no statistical difference between the pain and swelling degree of the dentin particles group and the Bio-oss group;Compared with Bio-oss,patients have a higher acceptance of dentin particles.Conclusion:Within the confine of this study,we found that the lateral window of maxillary sinus floor elevation can achieve good bone regeneration under the condition of extremely insufficient bone height.Both dentin particles and deproteinized bovine bone matrix can achieve good bone regeneration effect,implant success rate and stability of bone graft material in the lateral window of maxillary sinus floor elevation.Dentin particles which comes from the patients themselves shows the advantages of simple preparation,low cost,patients preference,and can be used as a substitute for commercially available bone graft materials.In clinical practice,doctors should select suitable bone graft materials for maxillary sinus floor elevation according to the patient’s own conditions to achieve satisfactory clinical results.